The key to breathing easy

What you need to know about the coronavirus, originating in China but now having spread to Thailand and other countries

A visitor at the Bamrasnaradura Infectious Diseases Institute wears a germ mask. (Photo: Wichan Charoenkiatpakul)

First, the number of coronavirus-infected cases in China was only 27 when first reported at the end of December. Then, only three days later, the number rose to 44, before hitting 59 two days after that.

As of now, the novel coronavirus, which has been wreaking havoc mainly in the Land of the Dragon ahead of the Lunar New Year, has infected more than 2,500 people -- from the central city of Wuhan to Beijing, Shanghai and other cities -- with at least 80 deaths reported so far. Unfortunately, the virus eventually found its way out of China, with countries like Japan, South Korea, Macao, Singapore, Taiwan and even the United States being hit. Earlier this month, according to the World Health Organization (WHO), the Ministry of Health, Labour and Welfare in Japan reported its first imported case of laboratory-confirmed 2019 novel coronavirus from Wuhan. Last week, according to a New York Times report, a man in his 30s in Washington state was infected with the Wuhan coronavirus, the first confirmed case in America of a mysterious respiratory infection. The Chinese authorities last Thursday morning decided to close off Wuhan by cancelling planes and trains leaving the city, and suspending buses, subway services and river ferries within it.

The virus hit Thailand recently, with the first infected case having been reported earlier this month. The patient was a 61-year-old Chinese tourist travelling from China to Thailand. She was transferred to an isolation ward at the Bamrasnaradura Infectious Diseases Institute in Nonthaburi province after her infection was confirmed.

In total, Thailand has seen eight confirmed cases of novel coronavirus-infected patients. Last week, media outlets reported a British tourist was feared to be the first Western victim of the new virus outbreak, as he was admitted to a hospital in Phuket before being transferred to a private hospital in Bangkok. Being struck down with a lung infection while visiting Koh Phi Phi, 32-year-old Ashley Shorley was reportedly in critical condition and had to be transported by a specialised seaplane because his lungs could not cope with the high cabin pressure.

Although the WHO said it would consider declaring an international public health emergency over the outbreak, in Thailand there is no reason to be overly paranoid, said Dr Thanarak Plipat, deputy director of the Bureau of Epidemiology under the Ministry of Public Health's Department of Disease Control.

"In Thailand, the novel coronavirus infection is not yet considered a pandemic. So standard healthcare precautions like regular handwashing, avoiding crowded areas and wearing protective masks are adequate at this point," said Dr Thanarak.

The new strain of coronavirus, or the 2019 novel coronavirus, is believed to have originated in the city of Wuhan, the capital of Hubei province. A market, named the South China Seafood Market, was pinpointed as the centre of the outbreak. Coronaviruses are zoonotic, meaning they are transmitted between animals and people. Some of the first group of patients in Wuhan worked or shopped at a seafood market where live animals and wildlife parts were reportedly sold. The market was shut down on Jan 1.

But the belief that the coronavirus is transmitted only between animals and people could be a mere misunderstanding following the aforementioned case in Japan. Based on the WHO report, the Japanese patient -- a male in his 30s -- admittedly travelled to Wuhan in December and developed a fever earlier this month while staying there. However, he did not visit the problematic market or any other live animal markets in Wuhan. As he indicated, he was in close contact with a person suffering pneumonia. Last week, the Chinese health authorities confirmed human-to-human transmission and that 15 medical staff in the country have been infected.

"If you ask how the virus travels, I would say by plane," said Dr Thanarak.

If that's the case, then it's still worth asking: Should Thai people be worried?

There are three direct flights from Wuhan to Suvarnabhumi daily, and two flights daily to Don Mueang, as well as flights to Chiang Mai and Phuket. According to Dr Thanarak, around 10% of Chinese visitors coming to Thailand -- approximately 300,000 -- are from Wuhan. Yet the Bureau of Epidemiology deputy director firmly believes that Thailand is fully prepared when it comes to handling the new virus strain.

"Johns Hopkins University conducted research last year," said Dr Thanarak, citing the 2019 Global Health Security Index. "The study ranked Thailand sixth out of 195 countries when it comes to our ability to cope and be prepared for a pandemic. Thailand is defined as 'most-prepared' and is the only developing country in the top 10 ranking."

Despite such ranking, screening protocols are also key. Asst Prof Opass Putcharoen, chief of the Centre of Emerging Infectious Diseases, Chulalongkorn Memorial Hospital, said screening should be carried out all year round and suspected patients should be strictly quarantined.

"A protective mask -- the kind that can shield PM2.5 dust particles -- is able to prevent the contagion," he suggested. "Right now, given that many details are not yet clear from the country of origin [China], a close follow-up [with them] is crucial."

Renowned veterinarian Pattarapol Maneeorn of the Department of National Parks, Wildlife and Plant Conservation under the Ministry of Natural Resources and Environment admitted that wildlife is "a source of disease", which means that if wild animals can survive, so can humans.

"Biodiversity is key to every life on the planet," he explained. "If we can maintain the ecological balance, there will be no dangers. But the truth is, threats to the planet's biodiversity rip the right balance off from the planet, sabotaging nature and animals, which leads to natural disasters and diseases."

Pattarapol added that several activities are responsible for animal-to-human disease transmission, including changing environment, wildlife migration, disease mutation, emerging diseases and animal habitats being disturbed, coupled with other threatening activities from the human side, like animal hunting, slaughtering, trafficking, tourism, wildlife feeding and so forth. So the only way to stop disease transmission is to stop these harmful activities.

"Wildlife hunting is a significant contributing factor that brings animals closer to humans -- the result of a belief that animal parts contain medicinal benefits," added the veterinarian. "There are many more high-risk diseases waiting to be discovered. So human beings will be able to live as long as animals can too."

Now that the novel coronavirus is spreading across countries, apart from basic personal hygiene practices like frequent handwashing and getting a flu vaccine, Dr Thanarak offered advice for international travellers.

"A trip to Wuhan should not be planned unless it is extremely necessary. Yet if you really need to visit there, don't go to markets that sell animal carcasses, seafood and wildlife."

He concluded: "Thais in general should be able to live their normal lives -- except for healthcare personnel, who should take extra precautionary steps."

NOVEL CORONAVIRUS 2019

Signs and symptoms

  • Fever
  • Respiratory symptoms
  • Coughing
  • Shortness of breath
  • Rapid breathing
  • Sore throat or runny nose

Precautions for international travellers

  • Avoid close contact with people suffering from acute respiratory infections
  • Frequent handwashing, especially after direct contact with ill people or their environment
  • Avoid close contact with farm and wild animals, alive or dead
  • Travellers with symptoms of acute respiratory infection should practise coughing etiquette (maintain distance, cover coughs and sneezes with disposable tissues or clothing, and wash hands).

Information from the World Health Organisation (WHO).